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冷储存条件下,从机采血小板浓缩物中分离出的血浆成分。

Composition of plasma in apheresis-derived platelet concentrates under cold storage.

机构信息

Institute of Clinical Transfusion Medicine and Hemotherapy, University of Wuerzburg, Wuerzburg, Germany.

Central Laboratory, University Clinic of Wuerzburg, Wuerzburg, Germany.

出版信息

Blood Transfus. 2023 Jul;21(4):327-336. doi: 10.2450/2022.0057-22. Epub 2022 Aug 9.

Abstract

BACKGROUND

Compared to room temperature (RT, 22-24°C) storage, refrigeration of platelet concentrates (PC) may provide advantages due to lower risks of bacterial growth and increased responsiveness of platelets. However, storage at cold temperature (CT, 2-6°C) may also strongly influence the plasmatic composition of PC. This study analysed the content of plasma in apheresis-derived platelet concentrates (APC).

MATERIALS AND METHODS

APC were stored under blood bank conditions at CT or RT. On days 0 and 6, samples were drawn for analysis. Coagulation parameters comprised global coagulation assays, single factors or inhibitors. The distribution pattern of von Willebrand multimers was investigated by immunoblotting. Thrombin generation was assessed with a fluorescence assay. Immunological and clinical chemistry parameters were determined on automated analysers.

RESULTS

After storage at CT, coagulation factors V, VII, IX or protein S activity are partially reduced, but less compromised than under RT. There was a large reduction in Factor VIII levels and this was similar at both temperatures. In contrast to RT, von Willebrand Factor (vWF) activity was remarkably decreased at CT, and this was accompanied by the shift from high molecular to low molecular weight multimers. Thrombin generation showed improved preservation at CT. Other plasma proteins like immunoglobulins were stable at both conditions.

DISCUSSION

Refrigeration mediates a bivalent effect on plasmatic coagulation in APC. At CT, the partial reduction of labile coagulation factors is less emphasised. However, CT does not prevent Factor VIII depletion, but induces an additional loss of vWF activity by multimer cleavage. Preserved thrombin generation may indicate a higher hemostatic capacity for cold storage.

摘要

背景

与室温(22-24°C)储存相比,冷藏血小板浓缩物(PC)可能具有优势,因为其细菌生长风险较低,血小板反应性增加。然而,低温(2-6°C)储存也可能强烈影响 PC 的血浆成分。本研究分析了源自单采血小板浓缩物(APC)的血浆含量。

材料和方法

APC 在血库条件下于 CT 或 RT 下储存。在第 0 天和第 6 天抽取样本进行分析。凝血参数包括全局凝血检测、单一因素或抑制剂。通过免疫印迹法研究了血管性血友病因子多聚体的分布模式。使用荧光测定法评估了凝血酶生成。免疫和临床化学参数在自动分析仪上确定。

结果

在 CT 储存后,凝血因子 V、VII、IX 或蛋白 S 的活性部分减少,但比 RT 下的受损程度要小。VIII 因子水平大量减少,在两种温度下相似。与 RT 不同,CT 下 von Willebrand 因子(vWF)活性显著降低,并且伴随着高分子到低分子重量多聚体的转移。CT 下凝血酶生成的保存得到改善。其他血浆蛋白如免疫球蛋白在两种条件下都稳定。

讨论

冷藏对 APC 中的血浆凝血产生双重影响。在 CT 下,不稳定凝血因子的部分减少不太明显。然而,CT 不能阻止 VIII 因子的消耗,而是通过多聚体裂解诱导 vWF 活性的额外损失。保存的凝血酶生成可能表明冷藏具有更高的止血能力。

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Physiology of cold-stored platelets.冷藏血小板的生理学
Transfus Apher Sci. 2019 Feb;58(1):12-15. doi: 10.1016/j.transci.2018.12.011. Epub 2018 Dec 30.
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A review of commercially available thrombin generation assays.市售凝血酶生成检测方法综述。
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